32C-022 (14) 29 PLEASANT ST BP-2019-1273
GIs#: COMMONWEALTH OF MASSACHUSETTS
:Block:32C-022 CITY OF NORTHAMPTON
Lot:-000 PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS
permit: Building DO NOT HAVE ACCESS TO THE GUARANTY FUND (MGL e.142A)
Category:ROOF BUILDING PERMIT
Permit# BP-2019-1273
Protea# JS-2019-002060
Est.Cost:$22000.00
Fee: S154.00 PERMISSION IS HEREBY GRANTED TO:
Const.Class: Contractor: License:
Use Group: C PHILIP ANDRIKOIS 071107
Lot Siu(s0.ft.): Owner., JDANIELS LINDA
Zoning:CB(100]/ Applicant. C PHILIP ANDRIKIDIS
AT: 29 PLEASANT ST
Applicant Address: Phone: Insurance:
405 RYAN RD (413) 585.9171
FLORENCEMA01062 ISSUED ONS,SM019 0:00:00
TO PERFORM THE FOLLOWING WORK:STRIP, INSULATE & SHINGLE ROOF WITH
EPDM
POST THIS CARD SO IT IS VISIBLE FROM THE STREET
Inspector of Plumbing Inspector of Wiring D.P.W. Building Inspector
Underground: Service: Meter;
Footings:
Rough: Rough: HOUR# Foundation:
Driveway Final:
Fluah Final:
Rough Frame:
Gu: Fire Department Fireplace/Chimney:
Rough: Oil: Insulation:
Final: Smoke; Fival:
THIS PERMIT MAY BE REVOKED BY THE CITY OF NORTHAMPTON UPON VIOLATION OF
ANY OF ITS RULES AND REGULATIONS.
Certificate of Occupancy Signature:
FeeType: Date Paid: Amount:
Building 5/22/20190:00:00 $154.00
212 Main Street.Phone(413)587-1240,Fax:(413)587-1272
Louis Hasbrouck—Building Commissioner
File#BP-2019-1273 \ �`
APPLICANT/CONTACT PERSON C PHILIP ANDRIKIDIS ^tq
ADDRESS/PHONE 405 RYAN RD FLORENCE (413)585-9171 }v�
PROPERTY LOCATION 29 PLEASANT ST
MAP 329 PARCEL 022 000 ZONE CB(100V
THIS SECTION FOR OFFICIAL USE ONLY:
PERMIT APPLICATION CHECKLIST
CLOSED REQUIRED DATE
ZONINGFORM FILLED T
Fee Paid
Buildine PermitFilled out
Fee Paid
I)Tmf Construction, STRIP.INSULATE& S F WITH EPDM
New Construction
Non Structural interior renovations
Addition to Existing
Accessory Structurc
Building Plans Inc luded:
Owner/Statement or License 071107
3 sets of Plans/Plot Plan
THE FOLLOWING ACTION HAS BEEN TAKEN ON THIS APPLICATION BASED ON
INF9RMATION PRESENTED:
Approved_Additional permits required(see below)
PLANNING BOARD PERMIT REQUIRED UNDER:§
Intermediate Project Site Plan AND/OR Special Permit With Site Plan
Major Project: Site Plan AND/OR Special Permit With Site Plan
ZONING BOARD PERMIT REQUIRED UNDER: §
Finding Special Permit Variance•
Received&Recorded m Registry of Deeds Proof Enclosed
_Other Permits Required:
_Curb Cut from DPW Water Availability Sewer Availability
_Septic Approval Board of Health Well Water Potability Board of Health
Permit from Conservation Commission Permit from CB Architecture Committee
_Permit from Elm Street Commission Permit DPW Storm Water Management
_Demolition Delray
I N-✓t.^� S L t J
Signature of Building Official Date
Note: Issuance of a Zoning permit does not relieve a applicant's burden to comply with all zoning
requirements and obtain all required permits from Board of Health,Conservation Commission,Department
of public works and other applicable permit granting authorities.
Variances we granted only to those applicants who meet the strict standards of MGL 40A.Contact Office of
Planning&Development for more information.
7t1koe- it -4L bp§e.uorr'l I -_
Versionl.7 Commercial BuildingPermit May 15,2000
Department use only
City of Northampton Status of Permit:
Building Department Curb Cuuoriveway Permit -
212 Main Street Sewer/Septic Availability
Room 100 Water/Well Availability
Northampton, MA 01060 Two Sets of Structural Plans
phone 413-587-1240 Fax 413-587-1272 Plobsite Plans
Other Specify
APPLICATION TO CONSTRUCT,REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF,OR DEMOLISH ANY BUILDING
OTHER THAN A ONE OR TWO FAMILY DWELLING
SECTION 1-SITE INFORMATION b P--1q/a73
1.1 Property Address: This section to be completed by olBcs
Map 3,1,C_ lJ
Lot da- unit
Zq Pl e.-S.ire 5L. zone Oveday District
FJm SL District CB Dbbtat
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record:
x
Linjotpian; a9 P/ea.sra,af- 571
Nam(Pimn Current Mailing Address: F / n
Signaturef k
Te,V pirone KM ` O '1231
2.2 Authorized Anew:
L. r
. -PI"j. 1 Iy r• [ Nos R-`7�-... Rol j'�.,-e.. u.__..
Name(Print) Current Mailing Address:
Signature Telephone _
SECTION 3-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollars)to be Official Use Only
completed by peurnitapplicant
1. Building ZZOo� (e)Building Permit Fee
2. Electrical (b)Estimated Total Cost of
Construction from 6
3. Plumbing Building Permit Fee
4. Mechanical(HVAC) W ��
S. Fire Protection
6. Total=(1 +2+3+4+5) Check Number
This Section For Official Use Only
Building Permit Number Date
Issued
Signature:
Building CommoslonerMspector of Buildings Dale
4
Versionl.7 Commercial Building Permit May 15,2000
SECTION4-CONSTRUCTION SERVICES FOR PROJECTS LESS THAN 35,000
CUBIC FEET OF ENCLOSED SPACE
Interior Alterations ❑ Existing Wall Signs ❑ Demolition Repairs Additions ❑ Accessory Building[3
Exterior Alteration ❑ Existing Ground Sign❑ New Signs❑ Roofin-cof Change of Use❑ Other❑
Brief Description Enter a brief description here.
Of Proposed Work:
SECTION 5.USE GROUP AND CONSTRUCTION TYPE
USE GROUP(Check as applicable) CONSTRUCTION TYPE
A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ 1A 13
A-4 ❑ A-5 ❑ IS ❑
B Business ❑ 2A ❑
E Educational ❑ 2B ❑
F Facto ❑ F-1 ❑ F-2 ❑ 2C ❑
H High Hazard ❑ 3A ❑
I institutional ❑ 1-1 ❑ 1-2 ❑ I-3 ❑ 3B
M Mercantile ❑ 4 ❑
R Residential 13R-1 11R-2 13R-3 13 SA ❑
3 Storage ❑ S-1 ❑ S-2 ❑ 5B ❑
U Utility ❑ Specify:
M Mixetl Use ❑ Specify:
S Special Use ❑ Specify:
COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND/OR CHANGE IN USE
Existing Use Group: Proposed Use Group'.
Existing Hazard Index 780 CMR 34): Proposed Hazard Index 780 CMR 34):
SECTION 0 BUILDING HEIGHT AND AREA
BUILDING AREA EXISTING PROPOSED NEW CONSTRUCTION OFFICE USE ONLY
Floor Area per Floor(so
__ _....__.._ 1s. _. _..
1'�
2"' _. 2.
3b 3m
4m
q'^
Total Area(so Total Proposed New Construction (sf)
Total Height(0)
Total Height it
7.Water Supply(M.G.L.c.40,§54) 7.1 Flood Zona Information: 7.3 Sewage Dlaposal Sys4m:
Public 0 Private 0 Zone Outside Flood Zone❑ Municipal ❑ On site disposal system❑
01
Vcrsionl.7 Commercial Building Permit May 15,2000
8. NORTHAMPTON ZONING
Existing Proposed Acquired by Zoning
This Munn an In,filled in by
Budding Deyenn¢nt
Lot Size
Frontage
Setbacks Front
Side L: R: L: R: _...
Rear
Building Height
Bldg.Square Footage .
Open Space Footage %
IUt ar®minus bldg&pavni
p of Puking Spaces
Fill:
volume&Location
A. Has a Special Permit/Variance/Finding ever been issued for/on the site?
NO Q DONT KNOW Q YES Q
IF YES,date issued:
IF YES: Was the permit recorded at the Registry of Deeds?
NO O DONT KNOW O YES O
IF YES: enter Book Page- and/or Document N
B. Does the site contain a brook, body of water or wetlands? NO O DONT KNOW O YES O
IF YES, has a permit been or need to be obtained from the Conservation Commission?
Needs to be obtained O Obtained O Date Issued: _. _..
C. Do any signs exist on the property? YES O NO O
IF YES, describe size, type and location:
D. Are there any proposed changes to or additions of signs intended for the property ? YES O NO O
IF YES, describe size, type and location:
E. Will the construction activity disturb(clearing, grading,excavation, or filling)over 1 acre or is it part of a common plan
that will disturb over 1 acre? YES O NO O
IF YES, then a Northampton Storm Water Management Permit from the DPW is required.
Versionl.7 Commercial Building Permit May 15,2000
SECTION 9.PROFESSIONAL DESIGN AND CONSTRUCTION SERVICES•FOR BUILDINGS AND STRUCTURES SUBJECT TO
CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPACE)
9.1 Registered Architect:
Not Applicable ❑
Name(Registrant):
Registration Number
Address
Expiration Data
Signature Telephone
9.2 Registered ProMeslonal Englnaer(s):
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
.._.............. .
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Date
Name Area of Responsibility
Address Registration Number
Signature Telephone Expiration Data
9.3 General Contractor
Not Applicable ❑
Company Name'.
Responsible In Charge of Construction
Address
Signature Telephone
Versionl.9 Commercial Building Permit May 15,2000
SECTION 10-STRUCTURAL PEER REVIEW(TSO CMR 110.11)
Independent Structural Engineering Structural Paer Review Required Yes 0 No
SECTION 11 -OWNER AUTHORIZATION-TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner of the subject property
hereby authorize C TI-14• r•� A,-el"L IL'['� �/ ---- to
act on ehalf, in all�ma1tters relative to work authorized by this building permit application.
X �ndtt f'/ o /a�9
Signature of Omecr'� Date
I, C .Y �..(r Q /1±—�rlk-..L'1 .as Owner/Authorized
Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knovAedge
and belief.
Signed under the pains and pen of perjury.
ll1
Print Name
C '• ~J(iW /?/r�/r�. CCS S//.S//N
Signature of Date /
SECTION 12-CONSTRUCTION SERVICES
10.1 Licensed Construction Supervisor.( A Not Applicable ❑
Name of License Holder � f ��(1 rJ YT-Y`U"��� do71/�-7
License Number
Address /may Expiration Dal
Signature s� Telephone
SECTION 13-WORKERS'COMPENSATION INSURANCE AFFIDAVIT(M.G.L.c.152,§251
Workers Compensation Insurance affidavit must be completed and submitted with this application.Failure to provide this affidavit will result
in the denial of the issuance of the ilding permit.
Signed Affidavit Attached Yes No Q
City of Northampton 212 Main Street, Northampton, MA 01060
Solid Waste Disposal Affidavit
In accordance of the provisions of MGL c 40, S54, I acknowledge that as
a condition of the building permit all debris resulting from the construction
activity governed by this Building Permit shall be disposed of in a properly
licensed solid waste disposal facility, as defined by MGL c 111 , S 150A.
Address of the work: Z-10/
The debris will be transported by:
The debris will be received by:
Building permit number:
Name of Permit Applicant
Date Signature of Permit Applicant
The Commonwealth of Massachusetts
Department of IndustrialAccidents
I Congress Street,Suite 100
Boston,MA 01114-1017
rr'ww.massgov/dia
Wiliarkers'Compentation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers
TO BE FILED WITH THE PERMITTING AUTHORITY.
Applicant Information ��I_ ..1/.1- Please Print Legibly
Name(Bminess'OrganrzM
ationdividual): L.r�l' .--ei,"ah
Address: to
City/State/Zip: Phone#: S;,k f—
Areyan an employer?cheek ma appropriate hoe: Type of project(required):
I.❑1 run a employer with employees(fi,ll asel/m put-time).• 7. ❑New construction
Alunawlepopiemrorpemiershipmdlmvenocmpbyeeswmking fame in g. [3 Remodeling
�en,pi IN.workers comp.no. reynimd.] 9.
3❑1 am a lmmmwnmdoing ell wink myself.[No wmkers'comp.iv ..inquired]' 10❑DemolitionBuilding
s❑1 aa mmeownu and will be hiring connton acm wndum ct all work my property I will 1 ❑ a
m addition
euxve mut all connumrs enter have workers'eimematkm thsuan«in are sok 11.❑Electrical repairs or additions
proprietors with no employees. 12.❑Plumbing repairs or additions
5 l am a gmeml eonlmcmraM I love hired We siiti ccacwrs hinal.n meamckit ahcc 13�Roof repairs
These rohconmctors have eme ployeand have wodem'comivumnu
p- .
6.1—]We me a corporation anal in off m have exemised mew right ofexemption per MGL e. 14.❑Other
152.§I(4).mrd we have m empbyem.Mo wakens'comp.wswarcerequired]
aAny applicant mat checks box#1 must also fill out dm seevm below showing mevworkers'eomperwtioe polity iufommum.
'Homeowners who submit anis alridsva indicating they are doing all work arta men hire outside conwcmrs must submit a new amdevit as Tenting such.
icon ewon.mat check anis box must artxhed an additional sheet slowing me mac ofmc subtionascwm arta now whMcr or ml inose entities have
employe— Ifthe sub-contrusnrs have employees,they muse prande thea wnrkeri comp.policy number.
1 am an employer their is providing workers'compensation insurance for my employees. Below is the policy and job sire
information.
Insurance Company Name:
Policy#or Self-ins.Lie,#: Expiration Date:
Job Site Address: City/statc/Zip:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152,525A is a criminal violation punishable by a fine up to$1,500.00
and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
1 do hereby certify ander the pains andpenaldes of perjury thatthe informadom provided above is true and eorrect
Signature' Date:
Phone# '3p -?1 -7/
OJrcial use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees-
Pursuant to
mployes.Pursuantto this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in ajoint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152.§25C(6)also states that"every state or local licensing agencv shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152,¢25C(7)stats"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractor(s)morels),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP dos have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should
be occurred to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in_(city or
Own)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
I Congress Street, Suite 100
Boston, MA 02114-2017
Tel.#617-727-4900 ext. 7406 or 1-877-MASSAFE
Fax#617-727.7749
Revised 02-23-15 www.mass.gov/dia
The Shelburne Architects
Joseph P.Mattel&Associates,Architects& Planners ''^'"-�"
25 Guy Manners Raab
Shalburne. Massachusetts a1374-9630
rti
Date: May 17, 2019
Philip Anddkidis, Owner
Florence Roofing T.413.925.2594
77 West Street M:413,330.7Y9
West Hatfield, MA 01088 E:indar lccomcasrnet
copy to:cnandrikidis@comcast net, Ihasbrouck@northamptonma.gov
RE:29 Pleasant Street Trust Roof Project
Architect's Project Number 21906
At your request I have reviewed the condition of the parapets and the chimneys at 29 Pleasant Street, Northamp-
ton, MA.
We (you and 1)visited the roof area, yesterday. Staging was in place for easy access.The parapets are in goad
condition. I do not believe seismic bracing is required based on the width to height ratio of the parapets.
We discussed some minor repainting in some small areas and I suggested that when the flashing and counter
flashing is removed from around the chimneys that the covered masonry be evaluated for damage. If damage is
present I will need to look at it before the masonry is again covered up with roofing and flashing.
It is my understanding that all of the inboard sides of the parapets will be covered with adhered roofing membrane
that laps the tops and drapes over the facade as a part of this project.A metal termination (so-called gravel stop)
will be secured to the facade to secure the edge of the membrane.
I do not have any issue with you proceeding with the Work pending the Building Department's issuance of a per-
mit to proceed.
A final inspection by me will be required before a final sign-off can be achieved.
For the record,Jacob Smith Engineering and Design has submitted a letter to Linda Daniels dated December 12,
2016 regarding this roof area. It is my understanding that Linda Daniels is one of the building owners.
Sincerely,
Joseph P. Mattel, Principal Architect
The Shelburne AmMtects is a Full Service AreM1¢qural Fi,m Sural MA.W.GT,&NH, Page 1 of 1